3. CHAPTER 3
The ambulance comes to a stop in front of my ER. The man is worsening fast. He was conscious when we left the scene but passed out on the trip here. Between his dropping blood pressure, slowing heart rate, and paleness, I suspect internal bleeding. I called the OR on the way over to ensure someone would be ready when we arrive.
The EMT rushes around, fling open the back doors with a loud creak. I hop out to help unload the gurneys.
Sarah, who I left in charge of the floor rushes over. “How bad was it?”
“Bad. A lot more are coming. We need to clear space and pull out any extra beds. Oh, and call up to Helen and see if the ICU can accommodate some of our stable patients so we can clear more space down here.”
“Absolutely. Anything else?”
“Dr. Hart from the OR should be coming down. If you see him, this guy needs to go immediately.
“Okay. I’ll tell him.”
“Thanks.” I turn back to an empty ambulance. My head whips left to right, looking for her. I suck in a breath as I glimpse an EMT disappearing behind the automatic doors. I sidestep Sarah, quickly following.
She’s still unconscious, and her pulse is getting weaker. I place an order for blood to replenish what she’s lost and start an IV. A nurse could do these things, but I just can’t stomach anyone else touching her.
This is stupid! I have other patients and responsibilities.
She has a nasty head wound but will need a CT to determine the extent of it. There’re exposed bones, flayed skin, embedded glass, bruising, and lacerations everywhere, but my biggest concern now is the metal bar protruding from her upper thigh. Despite my worry for her, just touching her skin while examining her injuries sends a tingle up my arms.
What is this pull? Why am I having such a reaction to her? My instincts are trying to tell me something, but what? I’m treating her and she’s in the hospital now. What am I missing?
Dr. Hart strolls to the front desk, and Sarah dashes over. He takes one look at the patient and vitals. “Yup, he’s coming with me.” He nods at me. “What about her?”
“She may need it, but I’m ordering CT and X-rays first.”
He nods and turns away with the man.
I love and hate crazy busy nights like this; the time flies by, and the adrenaline rush is addicting. I move from bed to bed, assessing each patient. The problem solving is my favorite part. It’s like a riddle I’m trying to crack. The energy from a night like tonight can’t fully be explained. It’s like touching a live wire and it zaps right through you.
I hardly ever pay attention to the elevator dings, but I’m antsy since they took my window girl up for tests. My pulse quickens when a tech rolls her out and back to her designated space, and I beeline straight to them.
“What did you find out?”
“Her CT is fine. There’s some minor swelling, but nothing too alarming. Her X-rays show three cracked ribs and the severity of the broken ankle. Nothing else is broken, and the thigh wound isn’t deep. We gave her more O-negative because we couldn’t get an accurate result on her blood type.”
My brows furrow. “Why not?”
“Not sure. We tried three times, and it said inconclusive every time. But it’s worked fine on other samples tonight. I’m sure it’s just on the fritz or something. We’ll get it checked out during the day shift. But her pulse is getting stronger, and she’s stabilizing.”
“Hmm. Thanks. There’s another patient over there who needs to be sent up.” I nod toward a woman with a nasty head wound that Sarah’s tending to. The tech nods and makes his way over.
I sigh and my shoulders relax while looking over the window woman’s X-rays. It could’ve been so much worse. I brush my fingers across her upper arm, the need to touch her overpowering me. Wasn’t there more glass embedded in her arms? Tiny pieces have fallen to the bed around her. Maybe they were more superficial than I thought?
I lift her wrist to look at her torn-up palms and they look way better too. They still need stitches, but they’re not gaping like I recall. Maybe someone upstairs cleaned her up a little? They typically don’t, just run their tests and return them so they can rotate through more patients. Or maybe I’m just not remembering them well?
I’m losing it tonight. The adrenaline’s wearing off. Maybe I need to get another coffee or something.
I grab her file and jot down a list: areas to be stitched, the bar from her thigh still needs to be removed, and hands must be bound. All of which can be done here, in the ER, but the exposed bones of her ankle and ribs will need the OR. I should hand this list to a nurse and have them bandage her before the OR comes to take her up, but my gut spasms at the thought. No, I need to make sure she’s safe and I’m not missing anything.
Another ding. I set her charts down and make my way over to Dr. Hart and the man he’s returning from the OR. The man lifts his head groggily and reaches for his abdomen.
“Woah there.” Dr. Hart snatches his hand, placing it at his side. The man groans and lowers back into the bed.
“How’d he do?” I raise my voice to be heard over the growing volume of the filling ER.
“Better than I expected. His name’s Joshua. He appears to have been hit in the abdomen. There’s major bruising of the skin and some internal organs. I found the busted artery and repaired it easily. We’ve given him more blood and pain meds. He’s just starting to stir and will be in a lot of pain. He should also be monitored for a while to make sure his condition doesn’t worsen.”
I take his chart from Dr. Hart. “Okay, perfect. Thanks.”
“No problem. Any others needing my attention?” His grey-blue eyes survey the floor.
“There’s a woman that’ll need some fractures set, but she isn’t ready to go up.” I flip through Joshua’s file and the notes Dr. Hart made.
“Sounds good. Page someone from my floor to come get her once she’s ready.” He heads back to the elevator as Lana and Courtney enter the front door, following patients on gurneys. They position the patients in the last open bay and walk over to me.
I place Joshua’s chart in the stand at the end of his bed. Courtney and Lana stop a few feet from me. “How’s the scene looking?”
Lana wipes her brow with the back of her hand, smearing soot across her forehead. “Getting cleaned up. We’re expecting one more ambulance, and Nate and Mateo said they would hitch a ride back on it. What can we do here?”
“Take a breather if you need it.” They both look exhausted. “Once you’re ready to jump back in, there’re a lot of people who came in with minor wounds. Divide and conquer on sutures and bandaging. Start with whoever we can address and release the fastest. Leave the more complicated cases to the other Attendings and call for me if you have questions.”
They nod then Lana heads outside and Courtney aims for the breakroom. This insistent pull has me heading right back to my window woman. I lift her arm, head tilting and my brows furrowing. Her wounds… how do they look even better now? I lean over and snatch up her chart, flipping to where I just jotted notes down. Yeah… Over half the areas that needed stitches now don’t. There were so many cuts of varying degrees, but now… there are barely any scratches. What the hell?
I massage the bridge of my nose, pushing my heavy frames back into place. I know they were there; they’re jotted down in her chart. My mouth opens and closes while I look around for someone who can confirm I’m not losing my mind. But there isn’t anyone near who could help, and, of course, I didn’t let others work on her.
I vigorously shake my head. I mean, I’m happy she’s in a better state. But what the hell is happening to me? Am I having a stroke or something?
“Ahh.” Joshua’s moan snaps my attention to him. He lifts his head higher and pushes himself upward.
I rush over before he tries to move too much. Placing a stern hand on his shoulder, I press him back down.
“Hi, Joshua. I’m Dr. Keane, head of the ER. You were in a car accident and sustained internal bleeding, which required immediate surgery. It was successful and you’re expected to make a full recovery but will be in a bit of pain.” His eyes flutter then open fully. “Can you rate your current pain level from one to ten?”
“Definitely a ten,” he wheezes, his hand moving toward his stomach.
I grab it, pinning it to his side.
“Don’t touch that. You’ve just had surgery. Also, try not to move around too much so it doesn’t aggravate the wounds more.” I turn the dial on his IV. “I’m upping your pain meds so we can try to get that pain level down. Would you like some water?”
“I can get that, Dr. Keane.” Sarah steps up next to me.
“Joshua, this is our head nurse Sarah, who’ll look after you from here. Please try to avoid moving and call for her if you need anything.” Turning to her, I say, “Keep an eye on his vitals. He’s not allowed to move, and we need to get his pain level down considerably. He rated it a ten.”
“No problem, Dr. Keane.” Her light brown bob sways back and forth while she busies herself, checking and noting his vitals.
“Thank you, Sarah.” My jaw clenches, and I tilt, stretching my stiff neck. The stress of tonight is finally affecting me.
This uncontrollable compulsion to be next to my window woman has me turning back toward her bed. My heart skips a beat at the sight of a broad man in civilian clothing leaning over her. A short woman with bleached blonde hair stands beside the bed, flipping through her chart, and my hands clench into fists. What the hell?
I rush over, ripping the chart from her fingers. “Can I help you?” I snap.
Her head cocks, a sneer contorting her sharp features. Her eyes squint and gleam with superiority.
The man glances over then back down, not concerned with us. And my window woman’s head slowly sways toward me. She’s awake!
Our eyes meet. My face softens and my body warms. The almost grey color is so unique, with small golden flecks sparkling throughout. It lures me in further and I step closer in awe. My chest expands, and I take the deepest breath I’ve had in hours.
The tiny woman appears in front of me, cutting me off. My smile vanishes as she comes toe to toe with me and tosses her hair back with a knowing smirk. She’s trying to intimidate me, but she’s going to have to try harder. I’m 5’11 and she barely reaches my chest. And this is my ER.
She tips her chin up higher, making direct eye contact with me, the smirk shifting to a harsh smile. I want to talk to my window woman. Not dealing with this power-hungry girl with a Napoleon complex. But I can’t look away. I want to. I try to. With all my might, I try to…but I can’t. Goosebumps break out across my skin, sweat trickles down my spine, and my attention’s stolen and held captive by this short, rude—
“Hello, Dr. Keane. You did an amazing job rescuing and treating my friend here. You thought she was in worse condition, but she’s doing much better and is ready to be discharged.”
My muscles relax throughout my body, replacing my panic with peace and coaxing me toward calmness. But something isn’t right… Her injuries. The bar and the ankle? I attempt to turn my head, but it doesn’t move an inch. My voice strained and hushed as I ask, “But her injuries are—”
She speaks louder, cutting off my whispered question. “Her injuries are minor and have already been addressed.”
The man moves to the other side of the bed and pulls the metal bar from her leg in one swift motion. My patient cries out and lurches forward, face contorting in pain. With a firm hand, the man shoves her back against the bed while grabbing a towel and pressing it to the open wound.
My nostrils flare, rage clouding my senses, my attention fully snapping from the short woman in front of me to the man next to the bed. I yell and lunge for him. “What are you doing?”
The tiny woman grabs my arm before I can make it to the bed. She pushes me back forcibly with her hands against my chest and turns me away from the patient. When she snaps her fingers in front of my face, I look down at her out of instinct, my jaw clenched tightly. And I’m stuck.
Why can’t I look away? What’s happening?
“Don’t pay attention to him. Listen to me.” Her eyes hold me prisoner. I want to yell, but my body melts further. It’s a weird combination of alarm and sedation. My thoughts get cloudier as her voice pulls me in deeper…
“Her head wound is only a bump. Her ribs are merely bruised. The thigh is just a minor cut, and the ankle is only sprained. She just needs it wrapped up, some pain meds, crutches, and then she can be on her way.” I tense at the snap of bone, the woman’s groan churning my stomach. “Now, repeat that back to me.”
My voice is monotone. “Her injuries are minor and have already been addressed. Her head wound is only a bump, her ribs are merely bruised, the thigh is a minor cut, and the ankle is only sprained. She just needs it wrapped up, some pain meds, and crutches, and then she can be on her way.”
“Perfect. Now run along to get those items so we can get her home.” She turns away from me dismissively.
I blink rapidly, looking down at my hands, and cough to clear the hoarseness from my throat. “Uh, um, what’s her name?” My brows furrow and I lift her chart.
The man steps forward and yanks the chart from my hands. The woman sways like a cobra to be in my line of sight again. “Don’t worry about her name. It’s not important. Go get the items this Jane Doe needs.”
I nod without question and turn toward the supply room.
Something isn’t right. I know it. I feel it. But I can’t figure out what’s wrong.
I lean the crutches against the wall, and the stool scrapes over the linoleum flooring as I pull it up to the bed. I’m shaking, my hands are trembling, heart racing.
What’s the matter with me?
I flex my fingers and position the supplies to splint this patient’s ankle. Just touching her skin feels like stepping into a hot tub on a chilly night. Calm soaks into my system and slows my heart.
Odd. I glance up to see if she’s feeling this weird sensation too, but her eyes are squeezed tightly shut. I shake my head and start wrapping the ankle tenderly. Air hisses through her clenched teeth when I tighten and secure the last piece.
The man by her side is filling out discharge papers while the small woman talks intensely with Sarah and the tech who brought this patient down earlier. I bite my lip and clean up the supplies, watching with lowered brows. The tiny woman’s ripping up papers and cramming them deep into the bag slung over her shoulder. She jumps up to pull the X-rays down from the wall display and shoves them in her bag as well.
Why were there tests if she isn’t that injured? And why is this random lady taking them?
An awareness settles over me, I’m being watched. I push my black frames back up my nose and glance up, my hand pausing in midair when my gaze connects with my patient’s. Those grey eyes snag my full attention. I feel like I’m looking at a long-lost childhood friend, like I’ve known her my whole life. But I haven’t even spoken to her. I’m about to ask about her pain level just to hear her voice, to see if it’s as intriguing as her eyes. My mouth instantly dries.
The tiny woman returns, interrupting our moment. Ha, our moment? That wasn’t even a moment. Am I losing it today or what?
She takes the discharge papers from the looming man and waves her hand dismissively at him. “Go move the car around to the front and bring a wheelchair back with you.” He nods and leaves at her command.
She turns back to me with a forced smile. “Thank you, Dr. Keane, for all your help.” She hands me back the papers, and I’m trapped in her stare again. “Here are her discharge papers. She’ll be leaving now. You’ve taken such wonderful care of her and there’s nothing left to worry about. Forget that we were here. Repeat that back to me now.”
“I have her discharge papers. There’s nothing left to worry about, and you were never here.”
“Very good. Have a good day and go check on your other patients.”
I robotically walk back to Joshua and check his vital signs. My pulse is racing, and a dull throbbing forms behind my eyes, increasing by the second.
Am I getting a migraine? It has been an eventful evening.
I make my way from patient to patient, my gut clenching tighter and tighter. I feel like I’m forgetting something. Did I need to run an errand after work? Talk to someone? I have that feeling when something’s on the tip of your tongue, but you can’t grasp it. The harder you try to focus on it, the further away it seems.
I slump into a rolling chair at the front desk, looking over at the wall clock. Less than an hour left. I’m so ready to go home.